The Diabetes Challenge

A hard medical path shows signs of God along the way.

by Columba Smith

“Take Caleb to a nutritionist. I don’t like that recurring rash on his face.”

Alarm flickered in my heart. My ex-husband is a registered nurse, and I take his concerns about our three children’s health seriously, even if abruptly delivered.

Learned helplessness

The night before the appointment, I looked at my middle son’s pale face and gently ran my thumb over the dark smudges under his eyes. The rash stung his lips and chin. At 13, he looked so tired and ill.

I was in a state of learned helplessness. An expensive, healthful diet, free of sugar and refined foods; regular exercise; and dust barriers in his bedroom, with regular cleaning, all seemed useless against his constant struggle with allergies. I worried that he was destined for a lifelong struggle with allergy-related illnesses.

High blood sugar

The next morning, the nutritionist looked at me over her glasses, holding a urinary test strip between gloved fingers. “His blood sugar’s off the charts.”

“What does that mean?” I asked innocently.

“It means you need to get him to a doctor. He may need to take insulin for the rest of his life. The fact that he’s still walking and talking is testament to your efforts to provide good nutrition.”

Surprise and confusion

I gazed at her, not understanding. The nutritionist was usually so positive. I’d been hoping for reassurance, not an ominous “rest-of-his-life” statement. (The latter was my anxious language, not hers.)

Then too, I thought, maybe she’s overreacting. After all, she was trained in alternative medicine. But her recommendation surprised me because she was usually conservative with conventional medicine. Her beating-around-the-bush message confused me, too. I later learned that she was trying to inform me of Caleb’s condition without naming it. As a nutritionist, she could not legally diagnose conditions.

Losing hope, fighting fear

Later, Caleb and I sat in a dusty pink examination room, with sweetly messy children’s pictures taped to the walls. The pediatrician asked about my son’s recent unexplained weight loss, his excessive thirst, and his frequent need to urinate. Each of Caleb’s answers drove hope a little further away.

In the lobby of our next stop, a diagnostics lab, Caleb sat silently with heavy shoulders. I longed to comfort him, but by then I was struggling to stay afloat on a raging ocean of fear.


And then, God moved.

I hadn’t known my friend Lynn worked in the lab. For years I’d emulated her godly single parenting. Recently I’d begun praying fervently for her son, who had contracted Lyme’s disease as a newly married young man. Lynn was watching him fight for his life, wasting away, weak and in danger.

Now she rounded the corner and looked deeply into my eyes, her face the picture of concern.

“I don’t know what’s wrong, but it’s serious!” I explained, tears falling.

Lynn prayed with me and assured me that God would see us through. She knew; she was further along a similar road. Her words flew to my soul like a lifeline. I grabbed them and hung on.


At last, we reached the final stop of our diagnostic journey: Lucille Packard Children’s Hospital. There we met with another doctor and a team of specialists. They confirmed the pediatrician’s grim suspicion as kindly as possible: Caleb had type 1 diabetes.

The facts had cornered me at last. There was no escaping my son’s sudden, devastating life sentence.

Learning about diabetes

The team worked with me, gently prying my fingers off the empty hope that supplements and diet could simply repair Caleb’s battle-weary pancreas. I had so much to learn.

Type 1 diabetes is an autoimmune disease. Its causes are unknown. Symptoms show up a few years after the immune system has launched its attack on beta cells in the pancreas — the cells that manufacture insulin. Insulin opens the body’s cells to glucose. Without insulin, glucose remains in the blood.

Over many years, high blood glucose levels can damage various internal organs. Therefore, tight control of blood sugar, achieved by carbohydrate counting and complex, fluctuating insulin doses throughout the day, are essential for long-term health. An accidental overdose of insulin could result in a fatal low blood sugar, especially during sleep.

A time to cry

When the team had convinced me that Caleb would benefit from a shot of insulin immediately, they left us alone in the sterile hospital room. Caleb sighed and looked at me with tired eyes. He’d been quiet all day, taking in the crushing news.

Now he spoke. “Well, I guess I’m stuck with it.”

My heart broke. I realized the medical team was giving us space to cry, and we took it, forced to welcome a chronic grief that took up permanent residence in our family.

Move of God

But as we struggled to catch our balance, God was still working.

A leading endocrinologist in diabetes research phoned me that evening. “We’re studying the effects of extremely tight blood glucose control at diagnosis,” he explained. “Your son is a candidate. He’d get a cutting-edge insulin pump, and your family would have intensive training on the disease. Interested?”

“Absolutely!” I said, as soon as Caleb had agreed to participate. As a single mother homeschooling my children, I was already running on fumes. Often fatigued, and lacking math and science skills, I had doubted my ability to handle the complicated insulin doses that adolescent children need.


Caleb was given the high-tech pump, not usually available to the newly diagnosed for many months. The pump calculated everything from individualized insulin-to-carb ratios at different times of the day, to correction doses, and much more.

With it came a sensor that beamed his glucose levels to the pump every ten minutes. Caleb had been diagnosed just in time to fill the last spot in the study. It was a Godsend.


As the initial weeks passed, I researched type 1 diabetes so I could give my son the best support I could. Reading about the discovery of insulin was an education in gratitude. I wept as I learned that until the 1920s, type 1 diabetes was uniformly fatal, allowing children about eleven months to live after diagnosis.

With insulin’s discovery, type 1 diabetes was no longer a death sentence.

God had arranged my son’s survival decades before he was born.

Rescued by the rash

I traced God’s hand in the mysterious rash, too. When it first appeared that spring, the allergist had performed a full battery of reactant tests on Caleb, ranging from redwood pollen to cat dander. No specific cause could be pinpointed.

Had the rash’s second appearance not sent us to the nutritionist, Caleb’s condition might have gone undetected much longer, putting him into a coma, or worse. The rash, which I later learned was caused by mango skin, may have saved Caleb’s life.

Spiritual growth

Two years later, Caleb manages his disease competently. He is radiantly healthy. More importantly, God has used his disease to strengthen his faith. Type 1 diabetes must be carefully handled no matter how tired, busy, happy, distracted, or stressed its victim is. I’ve watched my son’s patience and maturity grow as he’s faced this reality squarely.

Diabetes has also deepened my son’s compassion. “This whole experience has put me through a huge learning process,” he told me. “I’ve learned not to judge people but to put myself in their place. I wouldn’t say that I prefer diabetes, but I sometimes wonder about the path I was headed down before I got it.”

Sustaining power

God didn’t prevent my son’s disease. Instead, He used it to prove His loving faithfulness through it. We have lived the promise in Isaiah: “When you pass through the waters, I will be with you; and when you pass through the rivers, they will not sweep over you. . . . For I am the Lord, your God, the Holy One of Israel, your Savior” (Isaiah 43:2, 3, NIV).

Although we have our bad days, God still sustains no matter how high the waters rise.